OBJECTIVE: To determine the long term effects of a conservative nurse-led intervention for postnatal urinary incontinence. DESIGN: Randomised controlled trial. SETTING: Community based intervention in three centres in the United Kingdom and New Zealand. PARTICIPANTS: 747 women with urinary incontinence at three months after childbirth, of whom 516 were followed up again at 6 years (69%). INTERVENTION: Active conservative treatment (pelvic floor muscle training and bladder training) at five, seven, and nine months after delivery or standard care. MAIN OUTCOME MEASURES: Urinary and faecal incontinence, performance of pelvic floor muscle training. RESULTS: Of 2,632 women with urinary incontinence, 747 participated in the original trial. The significant improvements relative to controls in urinary (60% versus 69%) and faecal (4% versus 11%) incontinence at one year were not found at six year follow up (76% versus 79% (95% confidence interval for difference in means -10.2% to 4.1%) for urinary incontinence, 12% versus 13% (-6.4% to 5.1%) for faecal incontinence) irrespective of subsequent obstetric events. In the short term the intervention had motivated more women to perform pelvic floor muscle training (83% versus 55%) but this fell to 50% in both groups in the long term. Both urinary and faecal incontinence increased in prevalence in both groups during the study period. CONCLUSIONS: The moderate short term benefits of a brief nurse-led conservative treatment of postnatal urinary incontinence may not persist, even among women with no further deliveries. About three quarters of women with urinary incontinence three months after childbirth still have this six years later.
Reproduced with permission from the BMJ Publishing Group.

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